Back to Search
Start Over
Monitoring nociception and awareness during palliative sedation: A systematic review
- Source :
- Palliative Medicine. 35:1407-1420
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Background: Providing unawareness and pain relief are core elements of palliative sedation. In addition to clinical scales, nociception and electroencephalogram-based depth of sedation monitoring are used to assess the level of consciousness and analgesia during sedation in intensive care units and during procedures. Aim: To determine whether reported devices impact the outcomes of palliative sedation. Design: Systematic review and narrative synthesis of research published between January 2000 and December 2020. Data sources: Embase, Google Scholar, PubMed, CENTRAL, and the Cochrane Library. All reports describing the use of any monitoring device to assess the level of consciousness or analgesia during palliative sedation were screened for inclusion. Data concerning safety and efficacy were extracted. Patient comfort was the primary outcome of interest. Articles reporting sedation but that did not meet guidelines of the European Association for Palliative Care were excluded. Results: Six reports of five studies were identified. Four of these were case series and two were case reports. Together, these six reports involved a total of 67 sedated adults. Methodological quality was assessed fair to good. Medication regimens were adjusted to bispectral index monitoring values in two studies, which found poor correlation between monitoring values and observational scores. In another study, high nociception index values, representing absence of pain, were used to detect opioid overdosing. Relatives and caregivers found the procedures feasible and acceptable.
- Subjects :
- Adult
Nociception
medicine.medical_specialty
Palliative care
Sedation
Conscious Sedation
Pain relief
Bispectral Index Monitor
Palliative sedation
03 medical and health sciences
0302 clinical medicine
Humans
Hypnotics and Sedatives
Medicine
Anesthesia
030212 general & internal medicine
Intensive care medicine
business.industry
Palliative Care
General Medicine
Anesthesiology and Pain Medicine
030220 oncology & carcinogenesis
Analgesia
medicine.symptom
business
Subjects
Details
- ISSN :
- 1477030X and 02692163
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Palliative Medicine
- Accession number :
- edsair.doi.dedup.....9a795e54af9b1799145563d718b9e249